scholarly journals Prediction of Sentinel Node Status and Clinical Outcome in a Melanoma Centre

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Vera Teixeira ◽  
Ricardo Vieira ◽  
Inês Coutinho ◽  
Rita Cabral ◽  
David Serra ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Standard Procedure ◽  
Univariate Analysis ◽  
Tumor Infiltrating Lymphocytes ◽  
Lymph Node Biopsy ◽  
Breslow Thickness ◽  
Tumor Type ◽  
Infiltrating Lymphocytes

Background. Sentinel lymph node biopsy (SLNB) is a standard procedure for patients with localized cutaneous melanoma. The National Comprehensive Cancer Network (NCCN) Melanoma Panel has reinforced the status of the sentinel lymph node (SLN) as an important prognostic factor for melanoma survival. We sought to identify predictive factors associated with a positive SLNB and overall survival in our population.Methods. We performed a retrospective chart review of 221 patients who have done a successful SLNB for melanoma between 2004 and 2010 at our department. Univariate and multivariate analyses were done.Results. The SLNB was positive in 48 patients (21.7%). Univariate analysis showed that male gender, increasing Breslow thickness, tumor type, and absence of tumor-infiltrating lymphocytes were significantly associated with a positive SLNB. Multivariate analysis confirmed that Breslow thickness and the absence of tumor-infiltrating lymphocytes are independently predictive of SLN metastasis. The 5-year survival rates were 53.1% for SLN positive patients and 88.2% for SLN negative patients. Breslow thickness and the SLN status independently predict overall survival.Conclusions. The risk factors for a positive SLNB are consistent with those found in the previous literature. In addition, the SLN status is a major determinant of survival, which highlights its importance in melanoma management.

Tumor-Infiltrating Lymphocytes Predict Sentinel Lymph Node Positivity in Patients With Cutaneous Melanoma

2007 ◽  
Vol 25 (7) ◽  
pp. 869-875 ◽  
Author(s):  
Rebecca C. Taylor ◽  
Ami Patel ◽  
Katherine S. Panageas ◽  
Klaus J. Busam ◽  
Mary S. Brady
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cutaneous Melanoma ◽  
Prognostic Significance ◽  
Tumor Infiltrating Lymphocytes ◽  
Breslow Thickness ◽  
Anatomic Site ◽  
Primary Cutaneous Melanoma ◽  
Male Sex ◽  
Infiltrating Lymphocytes

Purpose Tumor-infiltrating lymphocytes (TILs) are considered a manifestation of the host immune response to tumor, but the influence of TILs on outcome remains controversial. Studies evaluating the prognostic significance of TILs were published before routine examination of draining lymph nodes by sentinel lymph node (SLN) biopsy, the most important predictor of survival in patients with melanoma. The prognostic implications of TILs were re-evaluated in a large group of patients undergoing SLN biopsy at our institution. Patients and Methods All patients who underwent SLN mapping for primary cutaneous melanoma between January 1996 and July 2005 were evaluated. Univariate and multivariate analyses were performed to assess factors that predict SLN positivity and survival. Factors analyzed included Breslow thickness, ulceration, anatomic site, sex, Clark level, age, mitotic rate, and the presence (brisk or nonbrisk) or absence of TIL. Results Eight hundred eighty-seven patients underwent SLN mapping, and a SLN was identified in 875 patients (98.8%). The SLN was positive for tumor in 156 patients (17.6%). Multivariate analysis revealed that only Breslow thickness (P < .0001), ulceration (P = .0004), male sex (P = .03), and absent TILs (P = .0003) were independently predictive of the presence of SLN metastases. In melanomas with a brisk TIL infiltrate, the probability of a positive SLN was 3.9% as compared with 26.2% for melanomas in which TILs were absent. TILs were not an independent predictive factor for survival. Conclusion The absence of TILs, together with increasing Breslow thickness, presence of ulceration and male sex, predicts SLN metastasis in patients undergoing SLN biopsy for primary cutaneous melanoma.

scholarly journals Sentinel Lymph Node Predictors in Melanoma of Breslow Thickness 0.8-1.0 mm

2020 ◽  
Vol 4 (5) ◽  
pp. 431-437
Author(s):  
Luisa Fernanda Christensen ◽  
David Carr ◽  
Sheena Hill ◽  
Elizabeth Ramser ◽  
Jaime Abraham Perez ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Survival Data ◽  
Tumor Infiltrating Lymphocytes ◽  
Female Gender ◽  
Mitotic Rate ◽  
Lymph Node Biopsy ◽  
Breslow Thickness ◽  
Increased Risk ◽  
Metastatic Risk

Introduction: Current melanoma staging guidelines consider all patients staged T1b to have the same metastatic risk and recommends that sentinel lymph node biopsy (SLNB) be considered in this disparate group. The goals of this study were to specifically determine predictors of sentinel lymph node positivity and those predictive for obtaining a SLNB in melanomas of Breslow thickness 0.8 mm to 1.0 mm, which has not been previously studied.Methods: Retrospective review between January 1997 and July 2019 of patients with melanomas between 0.8 mm-1.0 mm in thickness. Patient demographics and primary tumor characteristics were correlated with SLN status.Results: Of the 458 patients found to meet Breslow thickness criteria, 223 (61.8%) underwent SLNB. Multivariate analyses demonstrated that < 60 years of age (OR 2.42), increasing Breslow thickness (OR 1.27), mitotic rate >1 (OR 2.32) and presence of tumor infiltrating lymphocytes (OR 3.33), were associated with performing a SLNB. Positive SLNB was found in 20 (8.1 %). Univariate analyses revealed females (p=0.016) to have an increased risk for positive SLNB.Limitations: Limited number of positive SLN and survival data available.Conclusions: Younger age, Breslow thickness ≥0.9 mm, mitotic rate >1, and presence of tumor infiltrative lymphocytes were found to be factors predictive of performing SLNB. Female gender significantly increased the odds of a positive SLN.

scholarly journals Predictive and Prognostic Value of BRAF and NRAS Mutation of 159 Sentinel Lymph Node Cases in Melanoma—A Retrospective Single-Institute Study

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3302
Author(s):  
Gabriella Liszkay ◽  
Zoltán Mátrai ◽  
Kata Czirbesz ◽  
Nóra Jani ◽  
Eszter Bencze ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Primary Tumor ◽  
Tumor Infiltrating Lymphocytes ◽  
Breslow Thickness ◽  
Lymph Node Status ◽  
Nras Mutation ◽  
Primary Tumors ◽  
Positive Slns ◽  
Infiltrating Lymphocytes

Purpose: To assess the prognostic role of sentinel lymph node status (SLN) in melanoma patients, a statistical comparison was performed with the application of already known prognostic factors, mutational occurrence of BRAF and NRAS in the primary tumor, as well as disease outcome. Methods: Our retrospective single-center study involved 159 melanoma cases, who underwent SLN biopsy. The following clinico-pathological data were collected: age, gender, location of primary tumor, Breslow thickness, ulceration degree, histological subtype, mitosis count, lymphovascular and perineural invasion, presence of tumor-infiltrating lymphocytes, regression signs, mutations of BRAF and NRAS of the primary tumors, and SLN status. Results: From the studied clinico-pathological factors, only Breslow thickness increased the risk of SLN positivity (p = 0.025) by multivariate analysis, while neither BRAF nor NRAS mutation of the primary tumor proved to be a predictor of the SLN status. While the NRAS-mutant subgroup showed the most unfavorable outcome for progression-free and distant metastasis-free survival, their rate of positive SLNs proved to be relatively lower than that of patient groups with BRAF mutation and double-wild-type phenotypes. Conclusion: Similarly to the importance of SLN positivity, NRAS mutation of the primary tumor proved to be an independent prognostic factor of progression. Therefore, despite negative SLN, this NRAS-mutant subgroup of patients still requires closer monitoring to detect disease progression.

scholarly journals Association between tumor-infiltrating lymphocytes and sentinel lymph node positivity in thin melanoma

2019 ◽  
Vol 94 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Fernando De Marco dos Santos ◽  
Felipe Correa da Silva ◽  
Julia Pedron ◽  
Roque Domingos Furian ◽  
Cristina Fortes ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Tumor Infiltrating Lymphocytes ◽  
Thin Melanoma ◽  
Infiltrating Lymphocytes ◽  
Sentinel Lymph Node Positivity

Combination of tumor multinucleation and spatial arrangement of tumor-infiltrating lymphocytes to predict overall survival in oropharyngeal squamous cell carcinoma: A multisite study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6566-6566
Author(s):  
Can Koyuncu ◽  
Germán Corredor ◽  
Cheng Lu ◽  
Paula Toro ◽  
Kaustav Bera ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Univariate Analysis ◽  
Tumor Infiltrating Lymphocytes ◽  
Spatial Arrangement ◽  
Risk Scores ◽  
Infiltrating Lymphocytes

6566 Background: Oropharyngeal squamous cell carcinoma patients can have major morbidity from current treatment regimens, necessitating accurate identification of patients with aggressive versus indolent tumors. In this study, we sought to evaluate whether the combination of computer extracted features of tumor cell multinucleation (MN) and spatial interplay of tumor-infiltrating lymphocytes (TILs) is prognostic of overall survival (OS) in OPSCC patients. Methods: OPSCC specimens from 688 patients were retrospectively collected from 3 different sites. 141 patients from site 1 formed the training set (D1) and 322 patients from site 2 and 225 patients from site 3 formed the independent validation cohort (D2, n = 547). A machine learning (ML) model was employed to automatically calculate a Multi-nucleation risk index (MNI), which is the ratio of the number of MN to the number of epithelial cells, to each patient. A separate ML model was also used to capture measurements related to the interplay between TILs and tumor cells (SpaTIL), which were then used to compute a risk score using a Cox regression model. The median value of both the MNIs and the SpaTIL risk scores in D2 were used to identify patients as either low- or high-risk. A definitive label was assigned to each patient by combining the class labels obtained from the MNI and SpaTIL models using a logical AND operation. Results: In D2, the patients with high-risk scores had statistically significantly worse survival in univariate analysis. The univariate analysis yielded an HR = 1.91 (95% CI: 1.25-2.93, p = 0.0027) for D. Multivariate analysis controlling the effect of different clinical variables is shown in the table. Conclusions: We presented a computational pathology approach to prognosticate disease outcome in OPSCC by combining features relating to density of multinucleation and spatial arrangement of TILs and validated the approach on a large multi-site dataset. With additional validation the approach could potentially help identify OPSCC patients who could benefit from de-escalation of therapy. [Table: see text]

scholarly journals The impact of sentinel lymph node sampling versus traditional lymphadenectomy on the survival of patients with stage IIIC endometrial cancer

2021 ◽  
pp. ijgc-2021-002450
Author(s):  
Dimitrios Nasioudis ◽  
Maureen Byrne ◽  
Emily M Ko ◽  
Robert L Giuntoli II ◽  
Ashley F Haggerty ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
Rank Test ◽  
Systematic Lymphadenectomy ◽  
Log Rank Test ◽  
Node Biopsy ◽  
To Receive

ObjectiveTo investigate the survival of patients with lymph node positive endometrial carcinoma by type of surgical lymph node assessment.MethodsPatients diagnosed between January 2012 and December 2015 with endometrial carcinoma and uterine confined disease and nodal metastases on final pathology who underwent minimally invasive hysterectomy were identified in the National Cancer Database. Patients who had sentinel lymph node biopsy alone or underwent systematic lymphadenectomy were selected. Overall survival was evaluated following generation of Kaplan–Meier curves and compared with the log rank test. A Cox model was constructed to evaluate survival after controlling for confounders.ResultsA total of 1432 patients were identified: 1323 (92.4%) and 109 (7.6%) underwent systematic lymphadenectomy and sentinel lymph node biopsy only, respectively. The rate of adjuvant treatment was comparable between patients who had sentinel lymph node biopsy alone and systematic lymphadenectomy (83.5% vs 86.6%, p=0.39). However, patients who had sentinel lymph node biopsy were less likely to receive chemotherapy alone (13.6% vs 36.6%, p<0.001) and more likely to receive radiation therapy alone (19.8% vs 5.4%, p<0.001) compared with patients who had systematic lymphadenectomy. There was no difference in overall survival between patients who had sentinel lymph node biopsy alone and systematic lymphadenectomy (p=0.27 from log rank test), and 3 year overall survival rates were 82.2% and 79.4%, respectively (p>0.05). After controlling for confounders, there was no difference in survival between the systematic lymphadenectomy and sentinel lymph node biopsy alone groups (hazard ratio 0.82, 95% confidence interval 0.46 to 1.45).ConclusionsPerformance of sentinel lymph node biopsy alone was not associated with an adverse impact on survival in patients with lymph node positive endometrial cancer.

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